Progressive Visual Field Loss in the Setting of Severe Orbital Fat Atrophy.

Prostaglandin analogues have a pivotal role in the management of glaucoma by effectively lowering intraocular pressure (IOP) and slowing disease progression. This study explores the complex case of an 81-year-old female with primary open-angle glaucoma, initially treated with travoprost. Despite controlled IOP, her visual fields deteriorated, particularly in the left eye. Investigations included sleep apnea tests, anemia blood tests, and orbital MRI, revealing optic nerve kinking. This case highlights the complex nature of glaucoma management, emphasizing the impact of mechanical stress on the optic nerve and the role of prostaglandin-induced orbital atrophy. The findings underscore the importance of personalized approaches, considering both pharmacological effects and individual anatomical variations.